title: Perioperative concerns in pediatric patients u10/1/2013ndergoing different types of scoliosis correction surgery: A retrospective observational study.
abstract: BACKGROUND
  Advances in scoliosis surgery have now made it possible for younger patients to be taken up for scoliosis correction.
  
  
  OBJECTIVE
  To ascertain the patient profile, perioperative complications and need for intensive care management in children undergoing posterior fusion and instrumentation (PF), anterior release (AR), and growth rod (GR) insertion surgery.
  
  
  METHODS
  After taking parental consent, data were collected retrospectively for 33 patients who underwent 37 procedures (four patients had both anterior and posterior procedures) on 2 days of the week mainly from August 2008 to February 2010 at a tertiary care institution.
  
  
  RESULTS
  Children undergoing GR surgery were younger (8.1 ± 2.1 years) than patients undergoing AR (12.9 ± 1.7 years) or posterior fusion (14.2 ± 2.2 years). AR children had a significantly higher Cobb's angle and more rigid curves. (P = 0.057) Associated congenital abnormalities especially neurological were commoner in the GR children. Surgical duration and blood loss was significantly more for PF (2207.5 ± 1224.13 ml) than GR (456 ± 337.5 ml), or AR (642.85 ± 304.72 ml), (P = 0.0002). PF patients needed Intensive care unit (ICU) care mainly due to the blood loss and prolonged surgery (35%). AR performed via thoracotomy was associated with the need for mechanical ventilation in 28.6%. The GR patients had major intraoperative hemodynamic events and 20% needed ICU care.
  
  
  CONCLUSIONS
  Post-operative ventilation may be required in 20-35% patients undergoing procedures for scoliosis correction. Despite GR insertion involving lesser blood loss; younger age, congenital abnormalities, positioning, and surgical manipulation resulted in life threatening events in these patients.
authors.affiliation: Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Anjolie
authors.initials: A
authors.lastname: Chhabra
authors.forename: Mahesh Kumar
authors.initials: MK
authors.lastname: Arora
authors.forename: Dalim Kumar
authors.initials: DK
authors.lastname: Baidya
authors.forename: Praveen
authors.initials: P
authors.lastname: Talawar
authors.forename: Preet Mohinder
authors.initials: PM
authors.lastname: Singh
authors.forename: Arvind
authors.initials: A
authors.lastname: Jayswal
keywords: Anesthesia for scoliosis surgery; growth rod insertion surgery; perioperative complications